Open source rules the world! Open-source/free software is everywhere.
The benefits of Open Source [to NHS trusts] are:
Ownership: Due to the vast configurability of open source software, Trusts have more control over the system. These modifications allow the technology to be completely bespoke to the Trust’s needs.
Accessibility: Open source software can be used and changed by anyone. This accessibility allows for constant developments and improvements made to the software.
Freedom: The supplier and maintenance needed to maintain the software are selected entirely by the Trust, with no lock in or long term commitments should situations change
Cost-effective: The licensing of open source software is significantly reduced compared to its proprietary counterpart.
Empowering: From clinicians to nurses, healthcare professionals have more input on software improvements and uses. This is bridging the gap between staff and technology, which will be critical for matters like the Paperless 2020 initiative.
Best Practice: Much like in the practice of medicine, open source runs on the philosophy of universally shared knowledge. New ideas and solutions are combined and promoted for the community’s benefit.
Source: https://www.england.nhs.uk/digitaltechnology/open-source/
“Open source software is less secure”
With all else being equal, open source code with many people (including, for example, paid security researchers) being able to review an application’s source code tends to make it more secure, not less.
“Open source is amateur or low-quality software”
Much of the internet runs on open-source software (e.g. Linux, Apache, PostgreSQL); many are maintained by top-tier engineers at Google, Meta, and others. Open-source tools are also becoming more commonplace in mission-critical systems e.g. hospital systems, banks and government.
“If we use open-source tools, we’ll have to release our work as open source as well”
The common open source licenses say nothing about needing to release the code for products that use open source libraries or software; we only have to give attribution. Only if we modify the code (for example, in the event we wanted to build a custom SCW version of a library or application) does the “copyleft” requirement apply.
“If we rely on open-source tools, we’d be snookered if they suddenly decided to close the source and start charging money”
The major open licenses are all irrevocable. Once a version of a tool or library has been released under an open license, that tool or library is open source in perpetuity. It’s always possible that (especially corporate-backed) projects could go closed-source for future versions, but in that case it is very likely that someone will take the last open version and “fork” it off into a separate project - this has happened many times e.g. LibreOffice from OpenOffice, MariaDB from MySQL.
“If we use an open-source tool on sensitive/proprietary data (e.g. SUS) we are at risk of this leaking out, or we are required to release it along with our code”
The open source licenses apply to the code itself, not the data we use it on. Even if we did decide to release one of our own products as open source, there is no requirement at all to publish any data alongside it. Furthermore, the fact that we can inspect the source code means we can assure ourselves as to how safe a tool is ourselves; with closed-source tools we have to trust the developer’s word for it (or, at best, an external security audit). Open tools such as R, python and PostgreSQL are in widespread use even with highly sensitive data (banks, governments, healthcare).
Widely recognised as one of the better government service portals, the gov.uk frontend is fully open source and hosted on GitHub by the Government Digital Service5.
Released by the Strategy Unit (part of Mids & Lancs CSU) earlier in 2025 as part of the New Hospital Programme, this Python-based 6 platform is designed to model future demand on hospital services using a complex and evolving set of inputs, parameters and outputs.
OpenEyes is an Electronic Patient Record (EPR) specifically designed for the ophthalmic specialty8 that is developed and released on Github under the AGPL open source license. It was developed in response to existing commercial EPRs being a poor fit. It has seen widespread success with universal deployment across Wales and Scotland and increasing rollout in England as well as international deployments.
A major benefit of the open-source model is that whilst every new hospital will have to be built brick by brick, nobody using a model to plan a hospital will ever have to start from scratch. Because it is open source, the NHP model can be developed, iterated and improved upon for many years to come.
Building on the example set by this model, openness should become standard practice for all NHS analytical tools. Sharing code transparently not only builds trust and ensures quality but also sets a benchmark for how such tools can deliver maximum public value.
- Chris Beeley, Head of Data Science, The Strategy Unit 9
Background reading
Open source in the NHS and UK Government
Contact:
Code & Slides:
at least not easily possible
with exception of some kernel components
there are technically differences, but the terms are often used interchangeably
a number of different open-source licenses exist today e.g. GPL, MIT and the BSD license. They all have slightly different legal terms and conditions.
SAT // Open Source Intro // Prepared in June 2025